Mechanical Devices Help Extract Cardiac Leads

Two new mechanical extraction platforms developed by Spectranetics (Colorado Springs, CO, USA) complement the laser-based technology that established the company's position in lead extraction, and expand physicians' options for safe removal of cardiac leads in the approximately 400,000 patients that will meet indications for a lead extraction procedure during 2014.

The TightRail rotating mechanical sheath platform combines unprecedented shaft flexibility and column strength to help physicians safely navigate the vasculature during cardiac lead extraction procedures. An advanced forward-facing dilating blade remains shielded until activated. The tip feature rotates in both directions for efficient dilation. The physician controls when the blade is exposed, for procedural safety.

The SightRail manual dilator sheath platform features visual indicators that show bevel orientation and tip alignment, supplementing fluoroscopy as a means to determine position and orientation. A longer inner sheath gives physicians improved ability to grip and manipulate the device, especially when advancing and rotating. Both the TightRail and the SightRail sheath set have received the European Community CE marking approval.

“In my experience, removing cardiac leads requires skill, patience and the right tools. Leads rarely take a straight course through the vasculature. Having a flexible sheath that follows the curvature of the lead and maintains alignment with the lead is critical to successful extraction,” said Prof. Charles Love, MD, director of cardiac rhythm device services at New York University Langone Medical Center. “Identifying bevel orientation can be challenging with fluoroscopy alone, so the visual direction offered by the SightRail sheath helps ensure proper sheath positioning and tip orientation when working in the superior vena cava.”

“Physicians consistently emphasize the need for the right tool at the right time for lead management. By providing a broader range of clinical solutions, our goal is to continue to enable safe, predictable outcomes in lead management,” said Scott Drake, CEO of Spectranetics. “Our confidence in the long-term strength of this business continues to be driven by the launch of our mechanical tools portfolio and increasing contribution from our sales force expansion.”

A key challenge in removing a pacemaker or defibrillator lead from the heart is overcoming the fibrous scar tissue that grows around the lead and adheres to it. The common procedure used delivers ultraviolet (UV) light generated by an excimer laser system to vaporize the scar tissue. This process frees the bound leads and enables the physician to remove the lead in a controlled and safe manner.

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